SYNCHRONIZED DC SHOCK IN LONG STANDING PERSISTENT ATRIAL FIBRILLATION WITH BIFASCICULAR BLOCK ENDING IN CARDIAC ARREST: A CASE REPORT
Amar Alhamdi a, Azad Jalal Ali b, and Nidham Alhassania c
a Division of Cardiology, Alhassani Heart Day Clinic, Sulaimani, Kurdistan Region, Iraq
b Department of Anesthesia, Shar Teaching Hospital, Sulaimani, Kurdistan Region, Iraq
c Divisions of Cardiology, Alhassani Heart Day Clinic, Sulaimani, Kurdistan Region, Iraq
Submitted: 15/5/2019; Accepted: 27/6/2019; Published: 21/9/2019
DOI Link: https://doi.org/10.17656/jsmc.10216
We report a case of long-standing persistent atrial fibrillation and bifascular block exposed to synchronized DC- cardioversion which resulted in cardiac arrest, the patient resuscitated including temporary and then permanent pacemaker implantation. The patient recovered fully and stayed in sinus rhythm. Patients with atrial fibrillation and symptomatic bifascular block, exposed to synchronized DC shock to revert into sinus rhythm, should receive either temporary pacing cover for the electrical cardioversion procedure, or should have at least a single ventricular permanent pacemaker prior to cardioverting them into sinus rhythm by applying synchronized DC – shock, as the likelihood of developing sinus arrest and escape rhythm failure is significantly high.
DC-Cardioversion, Atrial fibrillation, Bifascicular block.
1. Lown B, Perlroth MG, Kaidbey S, Abe T, Harken DE. “Cardioversion “ of atrial fibrillation . A report from the treatment of 65 episodes in 50 patients . N Eng J Med 1963;269:325-31.
2. Camm AJ, Lip GY, De Caterina R, Savelieva I, Atar D, Hohnloser SH, et al. 2012 focused update of the ESC guidelines for the management of atrial fibrillation .Developed with the special contribution of the European Heart Rhythm Association. .Euro-pace 2012;14:1385-413
3. Botkin SB, Dhanekula LS, Olshansky B. Outpatient cardioversion of atrial fibrillation : efficacy, safety and costs. Am Heart J .2003; 145:233-238.
4. Gronberg T, Neotio I, Nikkinen M, et al . Arrhythmic complications after electrical cardioversion of acute atrial fibrillation: the FinCV study. Europace ,2013;15:1432-1435.53.
5. Kottkamp H. Fibrotic atrial cardiomyopathy : a specific disease /syndrome supplying substrates for atrial fibrillation , atrial tachycardia , sinus node disease ,AV node disease and thromboembolic complications. J Cardiovasc Electrophysiol 2012;23:797-799
6. Himansha M, Somashekhar G, Jayaprakash S, et al. Association of AF with significant interventricular conduction disease- A case report, Journal of Indian College of Cardiology JICC;5(2015) :157-159.
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